Akaev Iolia, Yeoh Chit Cheng, Rahimi Siavash
School of Pharmacy and Biomedical Sciences, University of Portsmouth, St. Michaels Building, White Swan Road, Portsmouth PO1 2DT, UK.
Department of Oncology, Portsmouth Hospitals University NHS Trust, Southwick Hill Road, Portsmouth PO6 3LY, UK.
Diagnostics (Basel). 2021 Mar 3;11(3):429. doi: 10.3390/diagnostics11030429.
Endometrial stromal tumours (ESTs) are rare, intriguing uterine mesenchymal neoplasms with variegated histopathological, immunohistochemical and molecular characteristics. Morphologically, ESTs resemble endometrial stromal cells in the proliferative phase of the menstrual cycle. In 1966 Norris and Taylor classified ESTs into benign and malignant categories according to the mitotic count. In the most recent classification by the WHO (2020), ESTs have been divided into four categories: Endometrial Stromal Nodules (ESNs), Low-Grade Endometrial Stromal Sarcomas (LG-ESSs), High-Grade Endometrial Stromal Sarcomas (HG-ESSs) and Undifferentiated Uterine Sarcomas (UUSs). ESNs are clinically benign. LG-ESSs are tumours of low malignant potential, often with indolent clinical behaviour, with some cases presented with a late recurrence after hysterectomy. HG-ESSs are tumours of high malignant potential with more aggressive clinical outcome. UUSs show high-grade morphological features with very aggressive clinical behavior. With the advent of molecular techniques, the morphological classification of ESTs can be integrated with molecular findings in enhanced classification of these tumours. In the future, the morphological and immunohistochemical features correlated with molecular categorisation of ESTs, will become a robust means to plan therapeutic decisions, especially in recurrences and metastatic disease. In this review, we summarise the morphological, immunohistochemical and molecular features of ESTs with particular reference to the most recent molecular findings.
子宫内膜间质肿瘤（ESTs）是罕见且引人关注的子宫间叶肿瘤，具有多样的组织病理学、免疫组化和分子特征。形态学上，ESTs类似于月经周期增殖期的子宫内膜间质细胞。1966年，诺里斯和泰勒根据有丝分裂计数将ESTs分为良性和恶性两类。在世界卫生组织（2020年）的最新分类中，ESTs被分为四类：子宫内膜间质结节（ESNs）、低级别子宫内膜间质肉瘤（LG-ESSs）、高级别子宫内膜间质肉瘤（HG-ESSs）和未分化子宫肉瘤（UUSs）。ESNs临床为良性。LG-ESSs是低恶性潜能肿瘤，临床行为通常惰性，部分病例子宫切除术后出现晚期复发。HG-ESSs是高恶性潜能肿瘤，临床结局更具侵袭性。UUSs表现出高级别形态特征，临床行为极具侵袭性。随着分子技术的出现，ESTs的形态学分类可与分子发现相结合，以对这些肿瘤进行强化分类。未来，与ESTs分子分类相关的形态学和免疫组化特征，将成为制定治疗决策的有力手段，尤其是在复发和转移性疾病中。在本综述中，我们总结了ESTs的形态学、免疫组化和分子特征，特别参考了最新的分子发现。
